With a 60 per cent rural population, how sustainable are India’s digital health initiatives?

India has been actively pursuing digital health initiatives to improve healthcare access, quality, and affordability across diverse strata of society. One of the initiatives includes the Ayushman Bharat Digital Mission. The mission aims to revolutionise India's healthcare system by leveraging technology to make services accessible to the poorest of the nation. Given that 60 per cent of the Indian population is rural, how effective is the reach of India's digital healthcare mission?

"The disparity in the rural-urban healthcare system in the country will hinder the potential of digital healthcare missions in India,"says Shyamal Santra, lead of public health and nutrition at Transform Rural India Foundation. He lays down the major pitfalls which impair India's efforts to take digital healthcare to the corners of the country:

Challenges that hinder India's digital healthcare mission:

Lack of access to digital technology
Rural areas in India still lack access to basic digital infrastructure like the Internet, smartphones, and computers. Without access to these technologies, digital healthcare solutions cannot be implemented effectively in remote areas.

Limited healthcare workforce
There is a significant shortage of healthcare professionals in rural areas of India. Although digital healthcare solutions can help bridge this gap by providing remote consultations, the overall healthcare infrastructure in these areas is weak, making it difficult to implement digital healthcare solutions.

Poor healthcare infrastructure
Many rural areas lack basic healthcare infrastructure, such as hospitals and diagnostic centers. Without these basic facilities, it is impossible to implement digital healthcare solutions in these areas effectively.

Lack of awareness and education
Many people in rural areas are not aware of the benefits of digital healthcare solutions. There is a lack of awareness and education about these technologies, making it challenging to leverage their potential in rural areas.

How effective is the Ayushman Bharat Digital Mission in taking India's healthcare services to the poorest of the nation?

Shyamal affirms that Ayushman Bharat Digital Mission has the potential to transform access to healthcare in India. By using technology to provide access to affordable and quality healthcare services to the most vulnerable sections of society, the mission takes a significant step towards achieving the goal of Universal Health Coverage, he added.

Digitising health care is the need of the hour for recording and sharing information, so that real-time data is available to policy-makers and program professionals. However, a myriad of problems remains unresolved which impacts the delivery of healthcare services offered by Ayushman Bharat Digital Mission.

Poonam Muttreja, executive director of Population Foundation of India highlights that the use of digital technologies requires affordability, accessibility to services, and quality of services, which is why there is a significant gap between rural and urban India. For example, according to NFHS-5, 66 per cent of females ever attended school in rural India while 82 per cent did in urban India. Similarly, disparities in the ownership and usage of gadgets are stark. For instance, while 69 per cent of urban women owned mobile phones (NFHS-5) only 46 per cent of rural women did. While rural Indians are at a disadvantage, rural women and girls are at a greater disadvantage.

Against the backdrop of India's G20 Presidency which has also prioritised 'Digital Health Innovation and Solutions to aid UHC and improve Healthcare Service Delivery', how can this model be made more effective to include the rural India belts that need better access to digital means?

One way to make digital health innovation and solutions more effective for rural India is to focus on addressing the infrastructure gaps in these areas. Shyamal suggests that this could be achieved by investing in better internet connectivity in rural areas, improving healthcare facilities in remote locations, and providing training to healthcare workers on how to use digital tools effectively.

Improving rural health care is crucial for India to make a difference in the lives of millions of people who depend on government-supported care. Poonam resonates by saying, "As the G20 leader, India needs to lead by example and put money where it matters. The first important input is a financial investment. India still spends around 1.4 per cent of its GDP on health care, which is quite low compared with our own commitment to raise it to 2.5 per cent by 2025. The problems of infrastructure, use of technology and digital technologies, lack of personnel, training and all other challenges can be addressed through increased financial investment and better management."

Another approach would be to leverage local partnerships and collaborations with government agencies, non-profit organisations, and private sector companies to develop scalable and sustainable digital health solutions that are tailored to the needs and preferences of rural communities.

Shyamal adds that promoting digital literacy and awareness among rural residents, especially women and marginalised groups, can help build trust and facilitate the adoption of digital health solutions in these communities.

How can we ensure that women and girls, who have evidently been left behind in the digital revolution in India's villages, become a priority in this global digital solution?

There are several steps that can be taken to ensure that women and girls are not left behind in the digital revolution in India's villages. Shyamal lays down a few:

Increasing accessibility
Access to technology and the internet should be made more accessible to women and girls in villages. This could be done by setting up community centres with computers and internet access, mobile internet vans, and providing affordable internet plans.

Digital literacy programs
Providing digital literacy programs specifically designed for women and girls can empower them to use technology to improve their lives. These programs can include basic computer skills, online safety, and financial literacy.

Encouraging entrepreneurship
Encouraging and supporting women's entrepreneurship in the digital sector can provide financial independence and increase their participation in digital transformation.

Gender-sensitive policies
Policies should be gender-sensitive and prioritise the inclusion of women and girls in digital transformation.

Public-private partnerships
The government and private sector should partner to promote digital inclusion for women and girls. This could include providing training and access to technology, as well as creating gender-sensitive digital content.

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